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Individual

BRIAN HUSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2400 UNSER BLVD SE, RIO RANCHO, NM 87124-4740
(505) 253-6100
Mailing address
PO BOX 26666, PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD2020-0583
NM
390200000X
Student in an Organized Health Care Education/Training Program
NM

Other

Enumeration date
04/11/2015
Last updated
08/04/2020
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